The One Pill Can Kill Myth

Abstract

“One Pill Can Kill” is a meme originating in the 1990s. This construct lists pharmaceuticals that have the alleged potential for fatality after the ingestion of a single pill by a toddler. However, its foundation is fundamentally flawed because it contravenes a basic principle of pediatric pharmacology, allometric scaling. Other than opioids, there are no literature examples of one pill killing a toddler. The negative outcome of the one pill can kill construct is inappropriate management manifested by over-referral of young children by poison centers to emergency departments for care, overly prolonged emergency department observation and needless hospital admissions. A more accurate construct is that one pill of anything other than opioids will not kill anybody with the caveat being that we are referring to regulated pharmaceuticals.

Ingestion of Fluids of the Ocular Surface Containing Eye Drops of Imidazole Derivatives—Alpha Adrenergic Receptor Agonists as Paragons

“…This could be because today’s understanding of frequently used imidazole derivatives refers to those used almost exclusively for local therapy, with the exception of some alpha-adrenergic agonists used as pills or patches [ 44 , 45 , 46 ].…”

“…These substances can be associated with CNS depression, bradycardia, and hypotension, but with proper medical care, patients usually do very well [ 43 ] ( Figure 2 ). Alpha-agonists’ toxicity may occur after ingestion of pills [ 44 , 45 ] or through the skin patches [ 5 , 46 ]. Be that as it may, this review focuses on the ingestion of conjunctival fluid mixed with eye drops.…”